Similarity Report ID: oid:26066:453921811

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0429081502

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1635 Words 10289 Characters

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9 Pages 141.3KB

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Apr 29, 2025 3:15 PM UTC Apr 29, 2025 3:15 PM UTC

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Summary
 8
CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Primary healthcare (PHC) is globally recognized as the bedrock of effective,

equitable, and sustainable health systems. Since the Alma-Ata Declaration of 1978,
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PHC has been central to achieving "Health for All" (World Health Organization,

2008). Across the world, well-functioning PHC facilities contribute significantly to

reducing morbidity, mortality, and improving population health outcomes. However,

the functionality and performance of the buildings housing these services remain

critical determinants of their success (Ilesanmi, 2010; Hinde, 2012).

Buildings designed for healthcare must not only serve their operational purposes but

must also support the comfort, safety, and satisfaction of both patients and staff

(Ilesanmi, 2010; Jiboye, 2012). Evidence has demonstrated that design quality,

environmental conditions such as ventilation, lighting, spatial layout, and

accessibility, significantly impact healthcare delivery efficiency and user experience

(Abbas & Ghazali, 2010; Department of Health, 2014). For instance, well-designed

hospital environments contribute to faster patient recovery, improved staff

productivity, and reduced hospital-acquired infections (Ulrich et al., 2008).

A major factor contributing to poor building performance is the lack of sufficient

understanding of users’ evolving needs by designers and facility managers (Natasha

4
& Abdul Hadi, 2008). Building Performance Evaluation (BPE) or Post-Occupancy

Evaluation (POE) provides a critical feedback mechanism, capturing users'

experiences and satisfaction to inform future improvements (Ibem et al., 2013; Said,

2012). Particularly in healthcare, regular evaluation ensures that facilities provide

therapeutic environments that actively promote healing (Abbas & Ghazali, 2010;

Dandajeh, 2011).

In Nigeria, the PHC system is vital for tackling key health challenges such as high

maternal and child mortality rates (Asuzu, 2004). Despite the establishment of

thousands of PHC facilities nationwide (Federal Ministry of Health, 2011), Nigeria

continues to struggle with poor health outcomes, partly due to infrastructural

inadequacies and maintenance deficits.

Potiskum, located in Yobe State, epitomizes these challenges. As a commercial hub

and one of the most populous towns in the northeast, Potiskum has witnessed rapid

population growth, internal displacement from insurgency, and increased demand

for health services (Adebayo, Adeniran, & Aliyu, 2015; Okeke, Iwu, & Chukwu,

2019). Unfortunately, many PHC buildings in Potiskum suffer from infrastructural

deficiencies such as inadequate spatial planning, poor ventilation, unreliable water

and electricity supply, and dilapidated sanitation facilities, all of which negatively

impact service delivery and user satisfaction (Adebayo et al., 2015).

Moreover, the impact of the Boko Haram insurgency has further strained healthcare

infrastructure by displacing communities, overwhelming existing facilities, and

diverting resources meant for infrastructural development towards emergency

responses (Okeke et al., 2019). As a result, the physical state of many PHC buildings

in Potiskum is poorly suited to meet current healthcare demands, undermining their

functionality and the well-being of users.

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Despite the critical role of building performance in healthcare outcomes, there is a

notable paucity of empirical studies assessing the functional performance and user

satisfaction of PHC buildings in Potiskum. Most existing evaluations are either

generalized at the national level or focused on secondary and tertiary healthcare

2
institutions. Therefore, this study aims to fill the gap by systematically evaluating

the functional performance and user satisfaction of primary healthcare buildings in

Potiskum, Yobe State, using Building Performance Evaluation frameworks to

provide evidence-based recommendations for future improvements.

1.2 Statement of the Problem

The physical characteristics of healthcare buildings play a significant role in

influencing user satisfaction and health outcomes. Studies have shown that the

design, functionality, and spatial quality of buildings directly affect how users
perceive and interact with healthcare services (Ibem, Opoko, Adeboye, & Amole,

2013; Jiboye, 2012). In Nigeria, conventional hospital and primary care designs

often fail to prioritize the needs of users, contributing to issues such as

overcrowding, poor ventilation, inadequate lighting, and lack of privacy. These

deficiencies have been associated with increased stress, anxiety, discomfort, and in

some cases, hospital-acquired infections (HAIs), particularly in poorly maintained

or aging health facilities (Atata, Ibrahim, Akanbi II, Olurinola, & Sani, 2006;

Dandajeh, 2011).

While a number of studies have examined healthcare infrastructure and building

performance at tertiary or general hospital levels, there remains a notable gap in the

evaluation of Primary Healthcare (PHC) buildings especially in rural and semi-urban

settings like Potiskum, Yobe State. Yet, PHCs are the closest point of care for over

70% of Nigerians and are intended to address more than 90% of the country’s health

concerns (Abdulraheem, Olapipo, & Amodu, 2012). The question arises: are these

buildings functionally efficient and satisfactory to their users? And to what extent

do they support safe, comfortable, and effective service delivery?

Potiskum, located in the northeastern part of Nigeria, has experienced rapid

population growth and infrastructural strain, compounded by insecurity and limited

government investment in health infrastructure. Despite being a major commercial

hub in Yobe State, many of its PHC facilities continue to operate in conditions that
fall below acceptable standards with limited space, deteriorated building finishes,

and poor access to essential utilities like water and electricity (Dandajeh, 2011).

These conditions not only affect the morale and productivity of healthcare workers

but also discourage patient patronage and reduce trust in public health systems.

There is a pressing need to assess the functional performance of PHC buildings and

the level of satisfaction experienced by users for both patients and health workers in

Potiskum. Without such data, policy decisions about infrastructure development and
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healthcare quality improvement remain uninformed. Therefore, this study seeks to

bridge that gap by evaluating the physical environment of PHC buildings in

Potiskum, using post-occupancy evaluation principles to determine how well these

buildings support the delivery of primary healthcare services and meet the

expectations of their users.

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1.3 Aims and Objective of the Study

The aim of this study is to assess the functional performance and user satisfaction of

Primary Healthcare (PHC) buildings in Potiskum, Yobe State, with the goal of

identifying design and operational shortcomings and proposing evidence-based

improvements that enhance user experience and support effective healthcare

delivery. To achieve the stated aim, the study sets out the following specific

objectives:
 1. To evaluate the functional performance of selected PHC buildings in

Potiskum..

2. To assess the level of user satisfaction among healthcare personnel and

patients regarding the physical environment and infrastructural condition of

PHC buildings.

3. To examine the relationship between the functional performance of PHC

buildings and user satisfaction.

4. To identify specific design-related and operational deficiencies in PHC

facilities that may compromise service delivery or user experience.

5. To propose practical, context-sensitive recommendations for improving the

design, maintenance, and overall performance of PHC buildings in Potiskum.

1.4 Research Hypotheses

In line with the third objective, the study hypothesizes the following:

• Null Hypothesis (H₀): There is no statistically significant relationship

between the functional performance of PHC buildings and user satisfaction in

Potiskum, Yobe State.

 • Alternative Hypothesis (H₁): There is a statistically significant relationship

between the functional performance of PHC buildings and user satisfaction in

Potiskum, Yobe State.

5
1.5 Research Questions

To guide this investigation, the following research questions have been formulated:

1. How functionally effective are the selected PHC buildings in Potiskum in

terms of spatial layout, ventilation, lighting, thermal comfort, safety,

accessibility, and maintenance?

2. What is the level of user satisfaction (patients and healthcare staff) with the

physical environment of PHC buildings in Potiskum?

3. Is there a statistically significant relationship between the functional

performance of PHC buildings and user satisfaction in Potiskum?

4. What specific design and operational shortcomings exist within the PHC

buildings that may negatively influence healthcare service delivery or user

experience?

5. What context-appropriate design or maintenance recommendations can be

made to improve the functional performance and user satisfaction of PHC

buildings in Potiskum?
1
1.6 Significance of the Study

This study holds both practical and academic significance. From a practical

standpoint, it provides critical insight into the condition and usability of PHC

buildings in Potiskum, a town that has faced significant infrastructural and security
1
challenges. By identifying specific functional and user-experience shortcomings, the

study offers evidence-based recommendations that can support local and state

authorities, architects, and facility managers in planning future improvements.

1 4
Academically, the research contributes to the growing body of literature on post-

occupancy evaluation (POE) and building performance in healthcare infrastructure,

especially in low-resource and conflict-affected settings like northeastern Nigeria. It

addresses a documented research gap by focusing on primary healthcare buildings

facilities that are essential to over two-thirds of Nigerians but often overlooked in

infrastructure assessments. The findings will also support future studies seeking to

explore the relationship between healthcare architecture, user satisfaction, and

patient outcomes in similar environments.

3
1.7 Scope and Limitations of the Study
1.7.1 Scope of the Study
This study examines the functional performance and user satisfaction of Primary

Healthcare (PHC) buildings in Potiskum, Yobe State. It is limited to selected,

actively operational PHC facilities within the local government area and adopts a
 Post-Occupancy Evaluation (POE) approach to assess both the physical conditions

and user experiences of the buildings. The research focuses on key functional

parameters such as spatial layout, lighting, ventilation, thermal comfort,

accessibility, safety, and maintenance. The study evaluates satisfaction from both

healthcare staff and patients through a mixed-methods strategy, including physical

audits, structured questionnaires and checklist, in order to generate context-specific

insights that can inform future design, renovation, and policy interventions.

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1.7.2 Limitations of the Study
This research is geographically limited to PHC buildings in Potiskum LGA, and its

findings may not reflect the conditions in other parts of Yobe State or Nigeria with

differing socio-economic, climatic, or security conditions. The study’s timeline is

bound by academic deadlines, which may limit data collection to a single season,

affecting observations related to climate-sensitive parameters like thermal comfort.

Additionally, while user satisfaction surveys provide valuable insights, they are

subject to individual bias and perception, which may not always reflect the objective

state of the building’s performance. Despite these constraints, the study aims to offer

meaningful recommendations that reflect the realities of PHC infrastructure in

Potiskum.
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